Cardiac Defects: ASD, VSD, and PDA
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Questions and Answers

What is the primary purpose of aortic valvotomy?

  • To improve blood flow through a narrowed valve (correct)
  • To replace the aortic valve entirely
  • To decrease blood pressure in the left ventricle
  • To increase pulmonary blood flow

    • What condition is characterized by localized narrowing of the aorta?

  • Coarctation of the aorta (correct)
  • Ventricular septal defect
  • Tetralogy of Fallot
  • Pulmonary stenosis

    • What happens to pressure in the right side of the heart during defects with decreased pulmonary blood flow?

  • It decreases significantly
  • It remains constant
  • It equalizes with left side pressure
  • It exceeds pressure on the left side (correct)

    • Which of the following is a pathognomonic sign of coarctation of the aorta?

    <p>Absent femoral pulses</p> Signup and view all the answers

    In Tetralogy of Fallot, which defect is NOT one of the four components?

    <p>Atrial septal defect</p> Signup and view all the answers

    What is the primary effect of decreased pulmonary blood flow in cyanotic heart defects?

    <p>Increase in systemic vascular resistance</p> Signup and view all the answers

    Which of the following symptoms is typically observed in cases of coarctation of the aorta?

    <p>Headache and epistaxis</p> Signup and view all the answers

    What is the clinical implication of rapid and bounding pulses found in coarctation of the aorta?

    <p>Points to increased blood flow in upper extremities</p> Signup and view all the answers

    What is one of the complications that can arise due to the growth of the uterus during pregnancy?

    <p>Compression of blood flow</p> Signup and view all the answers

    Which of the following is a clinical manifestation of chronic venous insufficiency?

    <p>Dull aches in legs</p> Signup and view all the answers

    What role does compression therapy play in managing potential pregnancy complications?

    <p>It ensures that veins retain their proper shape</p> Signup and view all the answers

    What area is notably affected by venous stasis resulting from reflux of venous blood?

    <p>Deep veins</p> Signup and view all the answers

    What is a recommended position to alleviate symptoms during pregnancy?

    <p>Elevating the legs</p> Signup and view all the answers

    What is the primary goal of surgical repair for ASD 3?

    <p>To reduce excessive pulmonary blood flow</p> Signup and view all the answers

    What condition is characterized by an abnormal opening between the right and left ventricles?

    <p>Ventricular septal defect</p> Signup and view all the answers

    What is a common symptom of large VSDs?

    <p>Excessive sweating associated with feeding</p> Signup and view all the answers

    What medical treatment stimulates the muscles inside the PDA to constrict?

    <p>Indomethacin</p> Signup and view all the answers

    What type of defect is characterized by narrowing or stricture of the aortic valve?

    <p>Aortic stenosis</p> Signup and view all the answers

    What is the palliative treatment option for infants with severe symptoms due to ASD 3?

    <p>Pulmonary artery banding</p> Signup and view all the answers

    What is a significant risk factor for developing PDA?

    <p>Maternal exposure to rubella</p> Signup and view all the answers

    What is an indicator of pulmonary stenosis?

    <p>Decreased cardiac output</p> Signup and view all the answers

    What is a common non-surgical management technique for obstructive defects?

    <p>Balloon angioplasty</p> Signup and view all the answers

    What is the extreme form of pulmonary stenosis where there is no blood flow to the lungs?

    <p>Pulmonary atresia</p> Signup and view all the answers

    What is the main complication of supracardiac TAPVR?

    <p>Desaturation and hypoxemia due to mixed blood</p> Signup and view all the answers

    Which assessment finding is commonly associated with infracardiac TAPVR?

    <p>Moderate to severe congestive heart failure</p> Signup and view all the answers

    What surgical procedure is performed in treating TAPVR?

    <p>Creation of a new complete pulmonary artery</p> Signup and view all the answers

    Which of the following is a common clinical manifestation of venous thromboembolism?

    <p>Tenderness and warmth in the legs</p> Signup and view all the answers

    What is the primary goal of medical management for venous thromboembolism?

    <p>Prevent the thrombus from growing and fragmenting</p> Signup and view all the answers

    Which factor does NOT contribute to Virchow’s triad?

    <p>Increased blood flow</p> Signup and view all the answers

    What is a common risk factor for venous thromboembolism?

    <p>Endothelial damage</p> Signup and view all the answers

    Which prevention measure is effective for reducing the risk of DVT?

    <p>Compression stockings</p> Signup and view all the answers

    What is the significance of Homan Sign in diagnosing DVT?

    <p>It rarely returns positive results</p> Signup and view all the answers

    What symptom might indicate deep vein thrombosis rather than superficial vein issues?

    <p>Heaviness in the legs</p> Signup and view all the answers

    What is the primary characteristic of Primary Polycythemia or Polycythemia vera?

    <p>Overproduction of red blood cells by the bone marrow</p> Signup and view all the answers

    Which of the following symptoms is associated with secondary polycythemia?

    <p>Elevated uric acid levels</p> Signup and view all the answers

    What treatment is typically used to manage Primary Polycythemia vera?

    <p>Low-dose aspirin</p> Signup and view all the answers

    In Secondary Polycythemia, what is a common cause of increased erythropoietin production?

    <p>Congenital heart defect</p> Signup and view all the answers

    What is the main complication associated with Primary Polycythemia vera?

    <p>Hemorrhage</p> Signup and view all the answers

    What is a key laboratory finding in diagnosing Primary Polycythemia vera?

    <p>Presence of JAK2 gene mutation</p> Signup and view all the answers

    What is the recommended management for symptomatic patients with elevated red blood cell counts?

    <p>Therapeutic phlebotomy</p> Signup and view all the answers

    Which condition is least likely linked to the symptoms of Primary Polycythemia vera?

    <p>Hypoglycemia</p> Signup and view all the answers

    Which management strategy is prioritized for Secondary Polycythemia?

    <p>Treating the primary condition causing hypoxia</p> Signup and view all the answers

    Which of the following conditions is NOT commonly associated with Primary Polycythemia vera?

    <p>Acute renal failure</p> Signup and view all the answers

    Study Notes

    Sinus Venosus Defect (ASD 3)

    • Opening near the junction of the superior vena cava
    • May be asymptomatic or present with respiratory tract infections, dyspnea on exertion, and congestive heart failure
    • May experience feeding difficulties
    • Management options include cardiac catheterization or open heart surgery
    • Surgical repair aims to reduce excessive pulmonary blood flow and protect pulmonary vasculature from hypertrophy and irreversible pulmonary hypertension

    Ventricular Septal Defect (VSD)

    • Abnormal opening between the right and left ventricles
    • Small VSDs are usually asymptomatic and often close spontaneously during the first year of life
    • Large VSDs can lead to congestive heart failure (CHF) with symptoms like tachypnea, tachycardia, excessive sweating, hepatomegaly, frequent upper respiratory infections, poor weight gain, failure to thrive, feeding difficulties, and decreased exercise tolerance

    Patent Ductus Arteriosus (PDA)

    • Failure of the fetal ductus arteriosus to close within the first weeks of life
    • High risk factors include maternal rubella exposure during pregnancy
    • Assessment includes a machinery-like murmur, asymptomatic presentation, and signs and symptoms of CHF and decreased cardiac output
    • Management options include medical treatment with Indomethacin (Indocin) and surgical ligation

    Obstructive Defects

    • Blockage of blood flow in the heart due to narrowing (stenosis)
    • Can result in decreased cardiac output, ventricular hypertrophy, and pulmonary vascular congestion

    Aortic Stenosis

    • Narrowing of the aortic valve causes resistance to blood flow in the left ventricle
    • Assessment findings include a characteristic murmur and signs of decreased cardiac output in infants and exercise intolerance, chest pain, and dizziness when standing for long periods in children
    • Treatment includes minimally invasive procedures like aortic valvotomy or valvuloplasty, and valve replacement

    Coarctation of the Aorta

    • Localized narrowing of the aorta
    • Assessment includes absent femoral pulses, higher blood pressure in the upper extremities, and weaker or absent pulses in the lower extremities
    • Management options include balloon angioplasty and surgical resection with end-to-end anastomosis of the aorta

    Pulmonary Stenosis

    • Narrowing at the entrance to the pulmonary artery causing resistance to blood flow
    • Leads to right ventricular hypertrophy and decreased pulmonary blood flow
    • Pulmonary atresia is the extreme form with total fusion of the commissures and no blood flow to the lungs
    • Treatment includes balloon valvuloplasty and surgical valvotomy

    Tetralogy of Fallot

    • Four defects: pulmonary stenosis, VSD, overriding aorta, and supracardiac total anomalous pulmonary venous return (TAPVR)
    • Assessment involves a characteristic murmur, moderate to severe CHF, variable cyanosis, poor growth, and activity intolerance
    • Surgical treatment aims to close the VSD, implant a conduit and valve to connect the right ventricle with the pulmonary artery, and construct a single large vessel and aorta

    TAPVR (Total Anomalous Pulmonary Venous Return)

    • Pulmonary veins drain into the right atrium instead of the left
    • Classified based on location: Supracardiac, Infracardiac, and Cardiac
    • Blood mixes in the common great artery causing desaturation and hypoxemia
    • Surgical treatment aims to create a connection between the pulmonary veins and the left atrium

    Venous Thromboembolism (VTE)

    • Deep vein thrombosis (DVT) and pulmonary embolism
    • Often clinically silent and frequently underdiagnosed
    • Risk factors include endothelial damage, venous stasis, and altered coagulation
    • Pathophysiology follows Virchow's triad: endothelial damage, venous stasis, and altered coagulation
    • Deep veins may show edema, warmth, and prominence, while superficial veins may present with tenderness, redness, and warmth
    • Diagnostic exams include careful assessment of lower extremities and Homan's sign (although not entirely reliable)
    • Prevention measures include identification of risk factors, compression stockings and devices, early ambulation, leg exercises, low molecular weight heparin (LMWH), and lifestyle changes
    • Medical management aims to prevent thrombus growth and fragmentation
    • Nursing management includes monitoring for complications, providing comfort, and encouraging exercise

    Polycythemia

    • Classified as primary (Polycythemia Vera) or secondary
    • Primary Polycythemia Vera is due to a mutation leading to overproduction of red blood cells
    • Secondary Polycythemia occurs due to factors reducing oxygen reaching tissues, like smoking, high altitude, or congenital heart disease
    • Diagnosis includes elevated hemoglobin, positive JAK2 gene, and decreased serum erythropoietin
    • Clinical manifestations include ruddy complexion, splenomegaly, and symptoms from increased blood volume
    • Medical management for Primary Polycythemia Vera focuses on reducing risk of thrombosis and bleeding, and treating contributing factors
    • Medical management for Secondary Polycythemia involves treating the underlying condition and therapeutic phlebotomy

    Hemophilia

    • Group of bleeding disorders due to deficiency of specific coagulation proteins
    • Most common types include Hemophilia A and Hemophilia B
    • Characterized by excessive bleeding and prolonged clotting time
    • Treatment involves replacement therapy with missing coagulation factor
    • Management includes careful monitoring of blood coagulation factors and preventing bleeding episodes

    Vascular Disorders

    • Include conditions affecting blood vessels, such as venous thromboembolism and polycythemia
    • Management focuses on addressing specific causes and complications

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    Description

    Explore the characteristics and management of common cardiac defects including Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), and Patent Ductus Arteriosus (PDA). Understand their symptoms, potential complications, and treatment options to enhance your knowledge in pediatric cardiology.

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